When a Paradigm Turns Smug

The blog entry you are about to read probably should have been posted one week ago, when its topic—diabetes in suburbia—was more prominent in the news. But reading the Toronto Star’s coverage of the issue had me so hot under the collar I thought I ought to cool off before I wrote anything.

A recent Starcover story proclaimed that, according to a new study, “Diabetes lurks in suburbs.” The coverage included a map showing how the far reaches of Etobicoke and Scarborough had the highest rates of diabetes in the city. What frustrated me was the suggestion—forcefully made by the story’s authors, despite the researchers’ quotes to the contrary—that somehow car culture was partly to blame for the epidemic. This angle was even more pronounced in an ensuing Christopher Hume column, covering a second report on the matter by the Ontario Professional Planners Institute, which argued that the suburbs were unhealthy and that “planners must be on the front lines in the battle to get drivers out of their cars and build ‘active communities.”

What’s pernicious about all this is that it overlooks numerous basic facts inherent to the situation. One: driving a car doesn’t cause diabetes. Two: even if it did, the people who are afflicted with obesity and diabetes in these communities are too poor to own a car. The real chain reaction at work here goes like so: malnutrition causes diabetes, and poverty contributes to malnutrition. And the story of how poverty found its way out to the suburbs is more fascinating and more regrettable than anything that’s been reported thus far.

Not long ago, common sense held that downtown was the unhealthy place to live. The poor gravitated there; the streets were unclean and unsafe. So, the affluent (affluence being evidenced by ownership of a car) moved to the suburbs, where living was believed to be healthier and safer—which, if we’re going to be honest about the matter, it truly was, at least for a while. The built form helped make it so: low-density single-family housing meant cleaner air (at least in its early days) and also made it easy to keep track of your neighbours (you could count them on two hands, and you recognized their cars), which in turn made strangers immediately conspicuous.

Today, downtown has returned to a period of ascendancy. Gentrification is everywhere, and condos are selling like hotcakes. But gentrification is a culprit here because it has displaced those too poor to own a car to areas of the city where car ownership is essential to their ability to stay connected to the rest of the world. The affluent moved to the suburbs as a lifestyle choice, but the urban poor did not.

Yes, built form plays a role in the current problem. When fast-food outlets are more numerous and more easily accessible than grocery stores, as is the case in the suburbs, it can contribute to malnutrition. But it’s not the source of the problem. The evidence is right there on the Star’s map: the still-affluent suburban corridor up Yonge Street, where people own lots of cars and use them for all their basic routines—getting to and from work, school, the grocery store, the drycleaner, the fitness club—shows no evidence of succumbing to the diabetes scourge. One of the lessons here is that you can forge a healthy lifestyle out of any built environment if you have enough money.

But what’s truly bizarre about this debate is the general willingness to view a human-health problem as a bricks-and-mortar one—to turn a story about diabetes into a story about low-density housing. The buildings don’t need fixing; the people need help. And given that gentrification played a role in creating this problem, I am not inclined to believe that some sort of downtown-style re-gentrification of the suburbs will solve it.